Published May 19, 2026

59-Year-Old Woman Thought Bloating and Urinary Changes Were Postmenopause—Until Spotting Led To Ovarian Cancer Diagnosis

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Avoiding Misdiagnosis: The Importance of Seeking Multiple Medical Opinions

Karen Marez ignored bloating, cramping, and urinary changes because she thought they were related to postmenopause — until unexpected bleeding led to a stage 2 ovarian cancer diagnosis.
After undergoing surgery and chemotherapy, she now urges women to get checked if something doesn’t feel right.
Ovarian cancer has been called the “cancer that whispers,” because women often don’t experience symptoms until their cancer has already reached its late stages.
SurvivorNet offers a comprehensive guide to ovarian cancer features advice from some of the nation’s top gynecologic oncologists, to guide you through every stage of the diagnosis and treatment process. Check out SN Local, featuring 20 cities across the U.S., to explore expertise and community near you.
When it comes to your health, it’s okay to advocate for yourself. You understand your body better than anyone, so if something doesn’t feel right, speak up.
From a doctor’s perspective, every problem should have a diagnosis, a treatment, a plan for follow-up, and a plan for what happens next if the treatment doesn’t work.

Karen Marez, a 59-year-old mom from Washington state, initially dismissed her bloating, urination changes, and cramping as postmenopausal symptoms—until light vaginal bleeding prompted her to seek medical attention, ultimately leading to a stage 2 ovarian cancer diagnosis.

Sharing her story with MultiCare Vitals, the retired teacher recounted thinking her new symptoms were simply “part of life as a postmenopausal woman” and thinking her cramping was “really weird” as her last menstrual cycle was 14 years ago.

Once her cramps went away, she decided “something was wrong” when she noticed light vaginal bleeding.

Marez, who has a family history of fibroids on her maternal side, also suspected she had fibroids, but that wasn’t the case. Dr. Kelly N. Wright, a specialist in the Minimally Invasive Gynecologic Surgery Center at Cedars-Sinai, previously told SurvivorNet, “Uterine fibroids are benign (non-cancerous) tumors that are extremely common, with up to 80% of women having a fibroid in their lifetime. Many fibroids are small and cause no symptoms, and therefore can be monitored over time.

“We expect fibroids to shrink by about 30% at the time of menopause, and after menopause, they shouldn’t grow any further or cause new symptoms.”

However, sometimes fibroids do cause symptoms, similar to what Marez was experiencing, that can interfere with a woman’s quality of life. But that wasn’t the case for Marez.

An ultrasounds revealed she had abnormal endometrial lining and some masses, prompting her to undergo a follow-up MRI.

When both her doctor and radiologist suspected one of the larger masses to be cancer, she was referred to MultiCare gynecological oncology, and had an endometrial biopsy and more scans [CT scan and MRI] done.

Referring to how her period started back up after having a biopsy taken, she told MultiCare Vitals, “It was pretty clear we were dealing with something serious. There was a tiny bit of hope it could be benign, but with the reality that we will deal with it if it’s cancer.”

Her doctor successfully removed a large ovarian tumor, performed a minimally invasive robotic-assisted hysterectomy, and removed lymph nodes to determine whether the cancer had spread.

Marez’s doctor, Dr. Christopher Breed, tells MultiCare Vitals, “While this mass did represent a cancer and there were some early signs of spread, thankfully there were no clear signs of spread to the upper abdomen or out of the pelvis.”

Since cancerous fluid had accumulated in her body, which possibly caused her bloating, Marez also underwent six rounds of chemotherapy.

Now Marez warns, hoping to encourage other women to get checked sooner than later, “If you have a gut instinct something is not right, that’s women’s intuition. Listen to that, even if you can explain away some of your symptoms as menopausal.

“Get yourself to a doctor, because the majority of ovarian cancer cases don’t get diagnosed till stage 3 or 4, and five-year survivorship odds go down.”

As Marez understands cancer recurrence is possible, she concluded, “I wake up one strong, brave, determined day at a time.

“I’m so looking forward to ringing that bell at the Cancer Center in celebration of getting through my chemo treatments that have hopefully brought me to NED (no evidence of disease) status.”

Understanding Ovarian Cancer

Ovarian cancer has been called the “cancer that whispers” because women often don’t experience symptoms until their cancer has already reached its late stages. The symptoms that do appear at first are hard to identify as cancer.

“Ovarian cancer does not have any specific symptoms,” Dr. Beth Karlan, a gynecologic oncologist at UCLA Medical Center, told SurvivorNet.

The symptoms of ovarian cancer may include the following, according to SurvivorNet experts.

A feeling of bloating or fullness
Pain in the pelvis or abdomen
Nausea
Vomiting
Changes in bowel habits

WATCH: Treating ovarian cancer.

Meanwhile, a hysterectomy is a procedure that removes part or all of the uterus (or womb), often along with the cervix, according to the National Cancer Institute. Women who receive a diagnosis of uterine, ovarian, and cervical cancer may have their cancer treated with a hysterectomy.

The standard of care for ovarian cancer patients is chemotherapy, which helps many patients reach remission.

Ovarian cancer recurrence happens in “almost 25 percent of cases with early-stage diseases and in more than 80 percent with more advanced stages,” according to research published in Gland Surgery medical journal.

With recurrence a strong possibility for this disease, especially in the later stages of ovarian cancer, certain drug treatments to deal with it are giving many women hope.

Maintenance therapy is continued treatment after the patient finishes their initial treatment. After an ovarian cancer patient completes a round of treatments — such as surgery and chemotherapy — her doctor may recommend some form of maintenance therapy to try and delay possible recurrence. Maintenance therapy can involve taking an oral pill called a PARP inhibitor every day after chemotherapy and can keep cancer in remission longer.

Genetic testing helps doctors determine the best maintenance therapy.

WATCH: How your ovarian cancer responds to certain types of chemotherapies guides your future treatments.

Staging Ovarian Cancer

While medical professionals use the staging of ovarian cancer to analyze how serious the illness is, how best to treat it and to provide a discussion about survival statistics, Dr. Beth Karlan previously told SurvivorNet that, “The staging of cancers is really to help us with a dialogue, and the honesty of our outcome.”

She explained that if you detect any symptoms of ovarian cancer, and a visit to your doctor confirms the diagnosis, then the next step would be discussing the stage of your illness.

Stage I – Confined to the ovary
Stage II – Spread to pelvic structures
Stage III – Spread to abdominal structures
Stage IV – Spread outside the abdomen or inside the liver or spleen

As a general rule, the lower the stage ovarian cancer, the less the cancer has spread.

How Serious is My Illness? ‘Staging’ Ovarian Cancer

Stage one refers to the earliest stage. At this point, it is limited to one or both ovaries, and is considered a confined form of the cancer; it has not spread to distant sites in the body. Stage two is when the cancer has spread from one or both ovaries to other organs in the pelvis, which can include the side walls of the pelvis, one or both fallopian tubes, the back of the uterus and the rectum or sigmoid colon.

With stage three, the cancer is in one or both ovaries, and has spread beyond the pelvis area to the upper abdomen, either to the omentum (a fatty apron that stretches over the abdomen), or other surfaces within the abdomen, such as along the diaphragm, the surface of the liver or the spleen, or possibly, nearby lymph nodes. At this stage, it has still not spread to distant sites. Finally, with stage four, the cancer cells have spread beyond the abdominal cavity to other organs: tumors inside your liver (not just on the surface), inside the spleen, in and around the lungs or other organs outside the abdomen and pelvic region, and possibly to the bones.

Several factors go into deciding on what kind of treatment is best, depending on the type and stage of ovarian cancer, the age of the woman and whether she is planning to have children in the future. But surgery is usually the first treatment recommended, with chemotherapy for use after treatment.

For all four stages of ovarian cancer, two specific chemotherapy drugs are usually suggested. Chemotherapy is usually injected into a vein with an IV, given orally, or, in some cases, may be administered through a catheter directly into the abdominal cavity. There are currently two chemotherapies currently considered the backbone for the initial treatment of ovarian cancer.

“We do know that two medicines together are better than one,” says Dr. Karlan.

Understanding The Stages and Grades of Ovarian Cancer

Usually, a platinum compound (carboplatin), which kills ovarian cancer cells, and a taxane like paclitaxel (a chemical compound originally derived from plants, which interferes with the growth of cancer cells) are the therapies used. These two drugs are usually given as an IV into the vein, every three to four weeks.

Although, as with any chemotherapy, side effects can occur, Dr. Karlan tells us that even during this treatment, most women should be able to go about most of their daily routines, whether it is working or running a carpool, with the caveat that they will most likely feel more fatigue than normal.

“I say most, because they are going to be more tired. Nobody’s typical activity includes coming to a hospital for chemotherapy,” notes Dr. Karlan. After treatment, most women should be able to resume just about all their normal activities.

Taking Control of Your Ovarian Cancer Risk

Understanding Menopause

The National Institute on Aging describes menopause as “a point in time 12 months after a woman’s last period.” “The years leading up to that point, when women may have changes in their monthly cycles, hot flashes, or other symptoms, are called the menopausal transition or perimenopause.”

The average age women go through the menopausal transition, which usually lasts approximately seven to 14 years, ranges between ages 45 and 55.

“The duration can depend on lifestyle factors such as smoking, age it begins, and race and ethnicity,” the institute explains. “The menopausal transition affects each woman uniquely and in various ways. The body begins to use energy differently, fat cells change, and women may gain weight more easily. You may experience changes in your bone or heart health, body shape and composition, or physical function.”

Common symptoms of menopause include:

Hot flashes
Moodiness
Depression
Painful sex
Difficulty sleeping

How to Cope With Menopausal Symptoms

Dr. Therese Bevers at the University of Texas MD Anderson Cancer Center says women facing menopause can undergo “small lifestyle changes” to reduce the impact of symptoms. Some tips that she offers include:

Avoiding coffee before taking a morning shower
Reduce stress
Exercise regularly
Get adequate sleep
Quit smoking
Avoid certain beverages that trigger hot flashes, such as coffee, tea, and alcohol.

Menopause and Possible Cancer Risks

While Dr. Bevers says, menopause does not cause cancer, as women age, their risk of developing cancer rises.

“Starting menopause after age 55 increases a woman’s risk of breast cancer and endometrial cancer. That’s probably because she’s been exposed to more estrogen,” Dr. Bevers explains.

“During a woman’s menstrual cycle, estrogen stimulates the uterus and breast tissue. So, the more menstrual periods a woman has, the longer these tissues are exposed to estrogen.”

Dr. Bevers adds that women impacted by menopause at a later age may have an “increased risk of ovarian cancer” because they have had more ovulations.

WATCH: How to cope with body changes amid a health challenge.

“The same ways you reduce your cancer risk before menopause: exercise, eat a healthy diet, don’t smoke and avoid secondhand smoke, and maintain a healthy body weight,” Dr. Bevers adds.

“Research shows that gaining weight after menopause increases a woman’s risk of breast cancer, but losing weight after menopause can actually reduce your risk.”

Avoiding Provider Bias – Is Your Doctor Understanding You?

While your doctor has undergone years of training and practice, they are still human, and may come with their own set of biases that can impact how they treat patients.

To combat these biases and really get the most out of your interactions with your doctor, you should provide her or him with plenty of information about your life and ask plenty of questions when things aren’t clear. To better understand how you should approach conversations with your doctor, we previously spoke with Dr. Dana Chase, gynecologic oncologist at Arizona Oncology.

According to Dr. Chase, physicians, like many of us, can be a bit biased when seeing patients. She made it clear that these biases are rarely sinister, but rather unconscious and more subtle.

She explained, “We have certain beliefs that we don’t know about. We might look, for example, at an older woman, and just by the way she looks we might make certain assumptions, and we might not even know that we’re making these assumptions.”

Let’s Talk About Provider Bias

Clearing up misconceptions is important, but so is understanding what your doctor is telling you, Dr. Chase noted. Overall, she advises women to speak up and ask questions when they don’t understand something.

“It’s never a bad thing to ask for something to be repeated, or to ask the doctors to explain it in different terms.”

So next time you go to your physician, speak up if you need clarity, so your doctor can understand you and you can understand them.

Dr. Steven Rosenberg is the National Cancer Institute Chief of Surgery, and he previously told SurvivorNet about the advantages of getting input from multiple doctors.

Cancer research legend urges patients to get multiple opinions.

“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care. Because finding a doctor who is up to the latest of information is important,” Dr. Rosenberg said.

Questions for Your Doctor

If you’ve been diagnosed with ovarian cancer and are looking for ways to better understand your disease and treatment options, here are some key questions to bring to your doctor.

You can also turn to SurvivorNet’s proprietary AI tool, “My Health Questions,” which helps patients and caregivers navigate a new diagnosis and prepare thoughtful, personalized questions for their care team.

What type of ovarian cancer do I have?
What stage is my cancer in?
Do you recommend I get genetic testing for any gene mutations, such as the BRCA gene mutation?
What initial treatment options do you recommend?
What are the possible side effects of the recommended treatment, and how can they be coped with?
Will insurance help cover my recommended treatment?

WATCH: A New Wave of Cancer Patients Using SurvivorNet’s My Health AI Tools For Support